Important information about your Healthcare FSA or HSA
Starting Jan. 1, 2011, due to healthcare legislation
changes, you must submit a doctor’s prescription for
any over-the-counter (OTC) drugs or medicines to be
reimbursed for their purchase by your Healthcare Flexible
Spending Account (FSA) or Health Savings Account (HSA).
If you have an FSA, you will need to submit either a receipt along with the prescription or
a receipt that lists a prescription number.
If you have an HSA, you will need to keep the prescription along with the receipt for your
tax records to avoid IRS penalties.
You can also submit a copy of a receipt with an RX number for the item showing that a
prescription for the OTC drug or medicine has been issued.1
What medical expenses will not
require a prescription?
The new rule does not apply to:
• Medical equipment such as crutches and monitors
• Medical supplies such as bandages and
contact solution
• Diagnostic devices such as blood sugar test kits
Does this new rule affect my 2010
OTC purchases?
No, this change does not affect purchases of OTC
medicines and drugs in 2010, even if they are
reimbursed after Dec. 31, 2010.
Will I be able to use my healthcare
payment card to purchase OTC
medicines and drugs?
No. The card can no longer be used to purchase OTC
medicines or drugs. You will need to provide the
prescription and receipt to get reimbursed.
If a prescription has been written for these items,
a manual claim will need to be submitted for
reimbursement and include the prescription as
documentation for eligibility and reimbursement.2
For your convenience, here is a summary list of common items that can and
cannot be reimbursed without a doctor’s prescription:
Medical expenses that require a prescription
for reimbursement (includes examples)
Medical expenses that do not require a
prescription for reimbursement (includes examples)
Acid controllers: Pepcid AC®, Zantac®, Prilosec OTC®
Acne creams: Clearasil®, OXY®
Allergy and sinus: Alavert , Benadryl , Claritin , Sudafed
Antifungal (foot): Lamisil®, Lotrimin®
Antibiotic products: Bacitracin, Neosporin , triple
antibiotic ointment
Antiseptics and wound cleansers: alcohol, peroxide, epsom salt,
Betadine®, Hibiclens®
Anti-diarrheals: Imodium®, Kaopectate®
Baby electrolytes and dehydration: Pedialyte®, Enfamil® Enfalyte®
®
®
®
®
®
Anti-gas: Gas-X®, Phazyme®
Baby teething pain: Baby Orajel®, Baby Anbesol®
Anti-Itch and insect bite remedies: Caladryl , Lanacane ,
Sarna®, hydrocortisone
Contraceptives: condoms, female contraceptives
Antiparasitic treatments: Nix®, Rid®, lice treatments
Denture adhesives, repair, pain relief and cleansers: PoliGrip®,
Benzodent®, Plate Weld®, Efferdent®
Baby rash ointments and creams: Desitin®, Aveeno Baby®,
Boudreaux’s Butt Paste®
Diabetes testing and aids: Ascencia®, One Touch®, Diabetic
Tussin®, insulin syringes, glucose products
Cold sore remedies: Abreva®, Herpecin L®, Orajel®
Diagnostic products: thermometers, blood pressure monitors,
cholesterol testing
Cough, cold and flu: Robitussin®, Theraflu®, Vicks®, Halls®,
Cepacol®, Zicam®, Cold-Eeze®
Ear care: ear drops, syringes, ear wax removal kits, Debrox®, Similasin®
Digestive aids: Lactaid®, Lactase®, Beano®
Elastics and athletic treatments: ACE®, Futuro®, elastic bandages,
braces, hot and cold therapy, orthopedic supports and rib belts
Feminine antifungal and anti-itch: Monistat®, Gyne-Lotrimin®,
Vagisil®, Soothing Care®
Eye care: contact lens care, Visine®, Refresh Tears®
Hemorrhoidal preparations: Preparation H®, Tucks®
Family planning: pregnancy kits, ovulation kits
Laxatives (non-fiber): Dulcolax®, Ex-Lax®, Miralax®
Fiber laxatives (bulk forming): Benefiber®, Fibercon®, Metamucil®
(powder or pills)
Motion sickness: Dramamine®, Sea-band Wristband®, Bonine®
First aid burn remedies: Dermoplast®, Solarcaine®
Pain relief (includes aspirin)
Tylenol®, Advil®, Midol®, Bayer®
First aid dressings and supplies: Band Aid®, 3M Nexcare®,
Johnson & Johnson RED CROSS®, non-sport dressings and supplies
Respiratory treatments and vapor products: Primatene®,
Bronkaid®, Vicks Vapor Rub®, Sudacare®
Foot care treatment: corn and callus treatments, wart removers,
therapeutic insoles
Sleep aids and sedatives: Unisom®, Nytol®, Sominex®
Glucosamine and Chondroitin: Osteo-Bi-Flex®, Cosamin D®,
Flex-a-min®
Stomach remedies: Mylanta®, Maalox®, Tums®
Hearing aid and medical batteries
®
®
Home healthcare (limited segments): ostomy, walking aids,
decubitis/pressure relief, enteral/parenteral feeding supplies,
patient lifting aids, orthopedic braces/supports, splints and casts,
hydrocollators, nebulizers, electrotherapy products, catheters,
wound care, wheel chairs
Homeopathic remedies: Boiron® and Hyland® products
Incontinence protection and treatment products: Attends®,
Depend®, GoodNites® for juvenile incontinence, Prevail®,
Calmoseptine®, anti-fungals
1
2
A “prescription” means a written or electronic order for a medicine
or drug that meets the legal requirements of a prescription in the
state in which the medical expense is incurred and that is issued by an
individual who is legally authorized to issue a prescription in that state.
The OTC limitation is on drugs and medicine only. Other OTC items
such as bandages and contact lens solution are still eligible.
OTC Limitation and Healthcare Payment Cards—Inventory Information
Approval System, or IIAS, is a point-of-sale technology used by retailers
that accept healthcare payment cards. OTC items that are no longer
eligible will BE REMOVED from the IIAS authorized items list for
purchases with the payment card.
Premera Blue Cross is An Independent Licensee of the Blue Cross Blue Shield Association
022717 (11-2010)
Insulin
Nasal sprays, drops and inhalers: Afrin Spray®, Ocean Nasal Spray®
Oral remedies or treatments: salivia substitutes, mouth sore
treatments, dental repair, Salivart®, Anbesol®, Orajel®, Dentemp®
Prenatal vitamins: Stuart Prenatal®, Nature’s Bounty
Prenatal Vitamins®
Reading glasses and maintenance accessories
Skin treatments: Psoriasin®, MG217®, Dermarest® Eczema
Smoking deterrents: Nicoderm®, Nicorette®